The efficacy of Nebivolol on patient with mild or moderate mssential hypertension by different smbulatory blood pressure monitoring methods

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Objective To evaluate the efficacy of Nebivolol on patients with mild or moderate essential hypertension(EH) using different methods of ambulatory blood pressure monitoring.Methods Forty-seven patients with mild or moderate EH were enrolled as our subjects after a 2-week administration of placebo.They were administrated Nebivolol (5 mg) once daily for 12 weeks.All the patients completed ambulatory blood pressure monitoring before and after taking Nebivolol for 12 weeks.The overall and individual methods were used to calculate the trough-to-peak ratio (T/P ratio) and smooth index (SI).Results (1) For all of 42 patients treated with Nebivolol (5 mg) for 12 weeks,the systolic blood pressure(SBP),diastolic blood pressure(DBP) of the whole-day,daytime and nighttime after treatment were decreased compared to before treatment (the whole day:(144.1 ± 9.8),(124.4 ± 10.4) mmHg vs.(93.2 ± 6.3),(79.2 ± 7.2) mmHg;daytime:(148.9 ± 9.7),(128.3 ± 10.5) mmHg vs.(96.8 ±6.1),(82.2 ±7.5) mmHg;nighttime:(133.9 ± 11.9),(115.9 ± 12.0) mmHg vs.(85.7 ± 8.0),(72.5 ± 7.5) mmHg),and there was significant difference (t =8.06,8.74,8.00,8.82,5.75,and 6.57 respectively; P ＜ 0.01).T/P ratios of SBP/DBP calculated by overall method were 78.4％ (17.4/22.2) and 61.2％ (9.0/14.7),but it were (79.3 ±0.4) ％ and (58.5 ±0.5) ％ by individual calculation method.(2) Among 30 patients with better effect,the SBP,DBP of the whole-day,daytime and nighttime after treatment were decreased compared to before treatment (the whole day:(143.4 ± 9.1),(127.5 ±10.7) mmHgvs.(92.6 ±6.2),(81.6±7.6) mmHg;daytime:(147.8 ±9.1),(131.0 ±10.5)mmHg vs.(95.8 ± 6.4),(84.1 ± 7.5) mmHg; nighttime:(134.7 ± 11.6),(119.6 ± 13.2) mmHg vs.(86.2 ± 7.4),(75.2 ± 8.5) mmHg),and there was significant difference(t =11.18,12.77,11.14,12.85,7.37,and 8.74 respectively,P ＜0.01).T/P ratios of SBP/DBP were 78.9％ (18.3/23.2),75.3％ (11.6/15.4) and SIof SBP/DBP were 7.4(19.5/2.6),7.1 (14.2/2.0) calculated by overall method,but T/P ratios of SBP/DBPwere (78.4 ± 0.4) ％,(74.6 ± 0.4) ％ and SI were (1.35 ± 0.73),(1.34 ± 0.54) calculated by individualmethod.Conclusion Nebivolol (5 mg once daily) can significantly reduce ambulatory blood pressure.Overall calculation method is better than individual method in terms of assessing the time of durative action and smooth effect by trough peak ratio and smooth index. Key words: Hypertension ; Nebivolol ; Trough peak ratio; Smoothness Index; Ambulatory blood pressure monitoring